The purpose of this study was to compare changes in oxygenation in the Vastus Lateralis (VL) and Rectus Femoris (RF) muscles during a ramp-loaded bicycle exercise. Twelve healthy males participated in the experiment. The test consisted of a leg arterial occlusion at rest and a ramp-loaded exercise (20 watts/min) using a bicycle ergometer until exhaustion. The changes in deoxygenation in each muscle was measured by near infrared spectrometer (NIRS) . The probes of NIRS were placed on VL and RF approximately 12 cm above the right knee. Oxy-Hb/Mb signals from NIRS were calculated as 100% at rest, with 0 % being the lowest value during the leg arterial occlusion. Pulmonary gas exchanges (VE, VO₂, VCO₂) were measured with an expiratory gas analyzer. In 10 subjects, muscle oxygenation level in VL decreased linearly until the deoxygenation limiting point (DOLP) -the point in exercise at which the deoxygenation rate decreases noticeably. However, in 2 subjects, the DOLP was not detected, and the muscle oxygenation level decreased linearly until exhaustion. The muscle oxygenation level in RF also decreased linearly until 70%VO₂max, although the deoxygenation rate was smaller than that in VL. Thereafter, the muscle oxygenation level in RF continued to decrease until exhaustion. No DOLP was found in any subjects in RF. Compared with the muscle oxygenation level in RF at any points during the exercise, those in VL were lower until 90%VO₂max (P<0.001) . However, the difference in muscle oxygenation levels between VL and RF at exhaustion was not noted. This study indicated that the patterns of deoxygenation in VL and RF during a ramploaded bicycle exercise were different.

Objective: To clarify the barriers pharmacists face in handling patients with adverse drug events at community pharmacies and to propose solutions.
Design: Cross-sectional study.
Methods: One hundred-twenty-one pharmacists, who worked and experienced to work at community pharmacies (76.0%), hospitals (22.3%), or elsewhere, participated in this study.  All of them were divided into 12 groups and asked to note the barriers, and abstract and structure them through discussion in each group according to the KJ-method.  On the other hand, workers at community pharmacies including people with experience were also asked to fill out a prepared questionnaire on barriers.
Results: Six groups structured the barriers from the perspective of professional flow as pharmacists and the other groups structured them from the perspective of a medical care team.  The barriers emerging from both structures were (a) difficulty in identifying adverse drug reaction and assessing its grade at community pharmacies, (b) lack of standardized protocols for informing physicians from community pharmacies, (c) not being informed about a physician’s assessment of suspicious adverse drug reactions, and (d) difficulty in explaining adverse events to patients and their families.  Those barriers were reported by a high percentage of respondents to the questionnaire.
Conclusion: The barriers are all crucial in order to avoid health damage caused by medication at community pharmacies and should be urgently solved.